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RCH Nursing Competency Workbook – Chapter 2

Nursing Competency Workbook, 10th Edition

Chapter 2Generic Nursing Competencies

The Royal Children's Hospital (RCH) Nursing Competency Workbook is a dynamic document that will provide you with direction and assist you in your professional development as a nurse working at the RCH. The workbook also provides a record of your orientation and competency obtainment.Chapter 1 Includes resources for nurses and is complemented by the Royal Children’s Hospital (RCH) New Starter pack resources, Hospital Orientation and Nursing Orientation day, to provide an introduction to nursing at the RCH.Chapter 2 Generic Nursing Competency Assessment FormsChapter 3 Specialty Nursing Competency Assessment FormsAppendix 1Unit / Department Nursing Orientation

All chapters and appendices are downloadable as pdfs from the Nursing Education Website.

The RCH Nursing Competency Workbook developed by Nursing Education with input from specialist nurses at the RCH.

For further information contact:Melody TruemanDirector, Nursing Education T: (03) 9345 6716 | E: [email protected]

Workbook Edition 10 - Updated January 2018


mailto:[email protected]

Table of Contents Introduction to Chapter 2_____________________________________________________________________________________1

Completion of Supernumerary Time Checklist________________________________________________________________1

RCH Mandatory Annual Competencies______________________________________________________________________2

Essential Policies and Procedures__________________________________________________________________________2

RCH Generic Nursing Competencies________________________________________________________________________3

Feedback and Reflections________________________________________________________________________________4

Completion of Supernumerary Time Checklist_____________________________________________________________________5

Primary and Secondary Survey (Recognition of the Unwell child)______________________________________________________8

Care Planning & Time Management_____________________________________________________________________________9

Medication Administration___________________________________________________________________________________10

Essential Policies & Procedures________________________________________________________________________________11

Admission (Nursing)________________________________________________________________________________________13

Consent__________________________________________________________________________________________________14

Discharge_________________________________________________________________________________________________15

Documentation: Admission to Discharge________________________________________________________________________16

Family Centred Care________________________________________________________________________________________17

Growth & Development of the Neonate (0-4 weeks)_______________________________________________________________18

Growth and Development of the Infant (5 - 52 weeks)______________________________________________________________19

Growth and Development of the Toddler/Preschooler (1 - 4 years)____________________________________________________20

Growth and Development of the School Aged Child (5 - 11 years)_____________________________________________________21

Growth and Development of the Adolescent (12+ years)____________________________________________________________22

Hydration - altered (Basic)___________________________________________________________________________________23

Hygiene__________________________________________________________________________________________________24

Infection Prevention________________________________________________________________________________________25

Intravenous Cannula Management - Peripheral___________________________________________________________________26

Intravenous Fluid Management_______________________________________________________________________________27

Monitoring (Basic)__________________________________________________________________________________________28

Enteral Feeding____________________________________________________________________________________________29

Nutritional Requirements____________________________________________________________________________________30

Oxygen Therapy____________________________________________________________________________________________31

Pain assessment and management (basic)_______________________________________________________________________32

Preparation for Surgery and Pre- Anaesthetic Care________________________________________________________________33

Procedural Pain Management (Basic)___________________________________________________________________________34

Post-Sedation/-Anaesthetic Care______________________________________________________________________________36

Risk Screening & Management________________________________________________________________________________37

Skin Integrity______________________________________________________________________________________________38

Transfer of Patients_________________________________________________________________________________________39

Wound Assessment & Management____________________________________________________________________________40

CVAD Management_________________________________________________________________________________________41

Haematology and Biochemistry (Basic)_________________________________________________________________________42

Tube Insertion_____________________________________________________________________________________________43

Specimen Collection_________________________________________________________________________________________44

Transfusion Management (Red Blood Cell)_______________________________________________________________________45

Competency Feedback & Reflection____________________________________________________________________________46

Competency Feedback & Reflection____________________________________________________________________________47



Tick the allocated box to indicate that the competency has been completed.

You are required to complete the Competencies listed here within the supernumerary time allocated

You and your assessor (Preceptor or CNE/F) must sign and date that the above competencies have been completed within the supernumerary time allocated.

If the competencies listed are not completed within supernumerary time an individualised plan will be developed in consultation with your assessor (Preceptor or CNE/F) and NUM to support you.

The unit you are working on may require you to complete additional nursing competencies within your supernumerary time. To find out the additional competencies relevant for you in your area discuss with your assessor (Preceptor or CNE/F).

Introduction to Chapter 2Chapter 2 contains forms for the use of all nurses commencing work at the Royal Children’s Hospital (RCH) to assist in the attainment and demonstration of competence. By clearly setting expectations for the standards of care at RCH, the use and successful completion of these forms will assist in guiding safe neonatal, child and adolescent nursing practice. Detailed below is the purpose and function of each form including an example of how to complete the form. Due to conditions of employment, progress through Chapter 2 for BARO staff will be different to what is outlined here. Please refer to Appendix 1V, The RCH Nursing Competency Framework for BARO staff.Completion of Supernumerary Time ChecklistThis completion of supernumerary time checklist provides an outline of the competencies you are expected to complete within your supernumerary time. If you have not completed these competencies within the timeframe stipulated, an individualised plan including additional supernumerary time and learning objectives must be developed in consultation with your assessor and Nurse Unit Manager (NUM)/Manager. Figure 1 contains of an example of how to use the completion of supernumerary time checklist.Figure 1: Example of Completion of Supernumerary Time Checklist form

RCH Nursing Competency Workbook – Chapter 2 Page | 1

RCH Mandatory Annual CompetenciesThe mandatory annual competencies must be completed as soon as practical upon commencement of employment (preferably within your first month). These competencies are assessed within your unit by the Clinical Nurse Educator/Facilitator (CNE/F) or another nurse who is trained to conduct specific assessments. This will be communicated to you during your unit orientation. It is your professional responsibility to liaise with this individual to arrange the assessments recorded in this chapter. Once completed you must date and sign that competence has been attained. Mandatory competencies are completed on an annual basis thereafter. Figure 2 provides an example of the mandatory annual competencies form. Figure 2: Example of Mandatory Annual Competencies form

Essential Policies and ProceduresThe essential policies and procedures are listed in this chapter for your reference. By the end of your 10 week familiarisation period it is expected that you be familiar with the content of the listed policies and procedures. When you date and sign alongside each policy or procedure you are taking responsibility for ensuring you practice in accordance with these. Evidence of this will be apparent in your Professional Practice Portfolio (PPP) and Performance and Development Assessment Program (PDAP).Please note that there are a number of essential policies and procedures that relate directly to competencies. Where this is the case those policies and procedures have been included in the relevant nursing competency assessment form. Figure 3 describes how to complete the essential policies and procedures form.Figure 3: Example of Essential Policies and Procedures form


Each Policy and Procedure listed includes the direct link to assist you in locating the document on the intranet.

You must date and sign each of the Policies and Procedures as evidence that you are familiar with the content and take responsibility for ensuring you practice in accordance with them.

Each mandatory annual competency listed here has a link to the required assessment tools. Where possible there is also reference to the resources available and applicable to the specific competency. Where this is not the case please refer to the assessor for further information.

You must date and sign each mandatory annual competency as evidence of attainment.

RCH Generic Nursing CompetenciesThe RCH Generic Nursing Competencies focus on skills, knowledge, attitudes, values and abilities relevant for all nurses working in direct patient care and clearly set the standard of practice at the RCH. They are classified according to the timeframe within which they are required to be achieved; 10 weeks and 12 months. Competence may be attained sooner than the timeframe stipulated based on individual experience. Some units may require you to attain competence earlier than identified here (Please refer to the CNE/F aligned with your unit). Generally, there is no specific order in which to progress through the generic nursing competencies. There are a small number of competencies for which nurses working in some units may be exempt. If this is the case, details of any exceptions will be noted on the competency. Figure 4 describes how to use and complete the generic nursing competency assessment forms.

Figure 4: Example of Generic Nursing Competency form


Competency statement describes the outcome when overall competency is attained

Competency elements describe the individual elements required to attain overall competence, and are divided into Knowledge components, and Skill components

Once overall competence has been attained the competency can then be signed off by yourself and your assessor (Preceptor or CSN/CNF).

Where your assessor wants provide constructive feedback in relation to a competency, or when you have reflective comments, tick this box and go to the Feedback & Reflections section (at the end of the chapter).

Feedback and ReflectionsEach of the nursing competency chapter has a specific section for feedback and reflections. Your assessor can document constructive feedback relating to specific elements of the competency here. You can also capture evidence of reflection on your own practice as it relates to each of the competencies. Figure 5: Example of Feedback and Reflections form

Completion of Supernumerary Time Checklist1

1 Completion of Supernumerary Time Checklist does not apply for Nursing & Administration Workforce staff. For more information on what is required during your first shift or supernumerary time please refer to Appendix 1V.RCH Nursing Competency Workbook – Chapter 2 Page | 4

Competency name and element number(s) [e.g. K1 or S3a-c] should be documented in each instance.

If your assessor has provided any feedback each of you MUST sign and date below to document this has been discussed and agreed upon. This may or may not include any self-reflective comments.

When you are documenting your reflections, remember to note the competency, and to sign and date.

No signature from your assessor is necessary.

Upon completion of the allocated supernumerary time the nurse will have completed the following competencies:

RCH Mandatory E-Learning Competencies (subject to change)

1. Emergency management RACE response Completed 2. Infection Control: Hand Hygiene 2017 Completed 3. Workplace Health & Safety Completed 4. Wadja Aboriginal Family Place 2015 Completed 5. Our Ways of Working: Policies & Procedures Completed

RCH Nursing Clinically Essential E-Learning Competencies (subject to annual change)

1. Basic Life Support – Infant & Child Completed 2. Manual Handling – Smart Move Smart Life 2017 Completed 3. Nurse – Nursing Medication Awareness Package Completed

Competency: Primary and Secondary Survey (Refer to pages 14 and 15) Completed

Competency: Care Planning and Time Management (Refer to pages 16 and 17) Completed

Competency: Medication Administration (Refer to pages 16 and 17) Completed

Generic/Specialty Nursing Competencies (as determined by the unit)__________________________ Page.______ Completed __________________________ Page.______ Completed __________________________ Page.______ Completed __________________________ Page.______ Completed __________________________ Page.______ Completed

The nurse must have completed the above listed nursing competencies during supernumerary period.

Nurse Name…………………………… Signature ……………………… Date …../…../……….

Assessor (Preceptor or CNE/F)

Name…………………………… Signature ……………….……… Date …../…../……….

If the nurse has not completed all of the above listed nursing competencies an individualised plan including additional supernumerary time and learning objectives must be developed in consultation with the Nurse, Assessor and Nurse Unit Manager.

If the individualised plan agreed upon has not supported the nurse to complete the above listed nursing competencies, proceed to the Clinical Support Process.


MANDATORY COMPETENCIES

Basic Life Support (RCH Level 2) CompetencyAnnual Requirement *Successful completion of both the online and practical components are required annually

COMPETENCY ELEMENTS

K Successful completion of online learning-RCH Resuscitation eLearning Modules:

1. Basic Life Support - Infant &child eLearning module

Date:

S Skills Assessment Date:

Enables participants to practice their Basic Life Support skills as a team review ARC/ APLS Basic Life Support Guidelines review bag-valve mask ventilation (infant and child) review cardiac compression technique (infant and child)

Simulation Date:The First Three Minutes Simulation program enables participants to practice as a team to respond effectively to a collapsed and unresponsive patient in the first three minutes before help (MET team) arrives

Managing a ‘collapsed and unresponsive’ patient appropriate to the clinical setting

Medication Awareness & Competency- All nurses new to the RCH required to administer medications are expected to completeboth the online and practical components.

COMPETENCY ELEMENTS

K 1. Locate & read the Medication Management Policy & Medication Management Procedure2. Locate and utilize Medicines Information to complete online learning

AMH Children’s Dosing Companion Paediatric Injectable Guidelines Paediatric Pharmacopeia MIMS Online Drug Location Guide After Hours

3. Successful completion of online learning: RN’s/Medication Endorsed EN’s:

RCH Medication Awareness Package Date: Non IV Endorsed EN’s & Mental Health Nurses:

RCH Medication Awareness Package Date: without Intravenous Medications

4. Unit Specific Medication Awareness Package (at the discretion of the employing unit)

S Completion of a practical assessment of Medication Administration Competency as outlined in the RCH Nursing Competency Workbook Date:Nurses are required to have all medications double checked until they have successfully completed the medication competency.


Smart Move Smart LiftAnnual Requirement *Successful completion of both the online and practical components is required annually

COMPETENCY ELEMENTS

K 1. Locate and read the RCH Manual Handling Procedure 2. Locate and utilise the intranet based Smart Move Smart Lift Training Resources covering the

core competencies3. Successful completion of online learning:

SMSL Patient Manual Handling Date:

S Completion of a practical assessment of Patient Manual Handling Competency as outlined by the RCH SMSL Competency Assessment Tool Date:

Emergency ProceduresAnnual Requirement COMPETENCY ELEMENTS

K 1. Locate and read Emergency Management Policy and Emergency Procedures2. Successful completion of online learning: Emergency RACE Response and Management

of Clinical Aggression Date:

S There may be some opportunity to be involved in ward based evacuation drills coordinated by the Emergency Management Coordinator

Infection Control- Hand HygieneAnnual Requirement COMPETENCY ELEMENTS

K 1. Locate and read the Hand Hygiene Procedure2. Locate and utilize the ‘Wash Up’ Hand Hygiene resources on the intranet to complete online

learning3. Successful completion of online learning:

Infection Control: Hand Hygiene Date:

S Consistently demonstrate effective hand hygiene and participate in monthly unit specific auditing

Electronic Medical Record (EMR)All nurses new to the RCH required to complete EMR training and pass the assessment before accessing the patient record. COMPETENCY ELEMENTS

K 1. Attend EMR training2. Successful completion of online learning/assessment Date:

S Consistently demonstrate department specific workflows (completed with a competent EMR user)


Primary and Secondary Survey (Recognition of the Unwell Child)Competency Statement:The nurse is able to safely and effectively conduct a primary and secondary survey, identifying management of abnormal findings RCH references related to this competency: RCH intranet - Division Surgery- Surgery Resources Element Exemptions: Banksia (K2a-c), ACE Program (K1b-c, S3)

COMPETENCY ELEMENTS

K 1. Locate and read a. Nursing Assessment Clinical Guidelineb. Temperature Managementc. Thermoregulation in the preterm infantd. Observation & Continuous Monitoring Clinical Guidelinee. Escalation of Care & Modification Process Flowchartf. Medical Emergency Team Response procedureg. MET criteria clinical practice guideline

2. State the normal physiological values for a child:a. Less than one year of age b. One to four years of agec. Five to twelve years of aged. Twelve years of age and over

3. Discuss examples of management when there is compromise to: a. Airway b. Breathing c. Circulation d. Disability and Discomfort

4. Discuss examples of management when there are abnormal findings as the result of a Secondary Survey.

S 1. Demonstrate a Primary Survey including assessment of:a. Airway b. Breathingc. Circulationd. Disability and Discomfort

2. Demonstration correct documentation of observations on the observation Flowsheet in EMR3. Demonstrate ability to review trends in ViCTOR graph4. Identify abnormal findings as a result of conducting a Primary Survey including

a. Nurse or parent “worried about patient”b. Observations in the “Orange Zone”c. Observations in the “Purple Zone”

5. Document evidence of Primary Survey on Primary assessment Flowsheet in EMR6. Demonstrate a Secondary Survey including:

a. Exposureb. Further history c. Get vitals, including glucosed. Head to toe assessment

7. Identify abnormal findings as a result of conducting a Secondary Survey8. Document evidence of a Secondary Survey on Focused assessment flowsheet in EMR

I have demonstrated the necessary knowledge, skills, abilities and attributes to be deemed competent in this competency. I acknowledge that ongoing development and maintenance of competency is my responsibility and will be evidenced in my Professional Practice Portfolio.

□ Please indicate if there is written feedback or reflections related to this competency in the designated section of the workbook

Nurse Name: Signature: Date:

Assessor Name: Signature: Date:

Care Planning & Time ManagementCompetency Statement:The nurse will effectively plan care and manage time efficiently to attend to the care needs of patients.RCH Nursing Competency Workbook – Chapter 2 Page | 8

COMPETENCY ELEMENTS

K 1. Discuss resources available within the unit to assist in care planning2. Discuss nursing care requirements and identify expectations of care for patients admitted to

RCH

S 1. Create a time plan to attend to identified care requirements2. Prioritise care to manage competing demands3. Modify time plan to attend to changes in care requirements4. Complete time critical care requirements on time5. Ask for assistance when required and delegate as appropriate6. Accept assistance when offered7. Demonstrate accessing “Worklist” in the EMR to assist with care planning





Medication AdministrationCompetency Statement:The nurse demonstrates safe administration of medication.


COMPETENCY ELEMENTS

K 1. Identify the indication for the medication prescribed using the appropriate resource 2. Select the medication prescribed in the correct form as determined by the prescribed route3. Describe the process for self (patient or family) administration of medication4. Explain what an adverse drug reaction is and the nurse’s role and responsibility in the event

that one occurs5. State the six rights of medication safety including nurses, family and patients right to refuse

S 1. Demonstrate that dosage for the medication prescribed is correct using the appropriate resource

2. Demonstrate medication calculations and preparation for the liquid (oral/enteral) medication prescribed to ensure that the correct amount of medication is prepared

3. Demonstrate medication calculations and preparation for the injectable medication prescribed to ensure that the correct amount of medication is prepared

4. Demonstrates checking of the patient in accordance with the Patient Identification Procedure against the medication prescribed on MAR.

5. Discuss with patient and/or family what medication is being administered, why it is being administered and the potential side effects

6. Demonstrate negotiation of who will administer the medication with the patient and/or family

7. Administer the following medications in accordance with the Medication Management Procedure:

a. Oral/ Enteral/ Topical medication b. Injectable medicationc. Scheduled eight medication

8. Document administration of the medication prescribed in accordance with the Medication Management Procedure on MAR in EMR

9. Describe how to identify that the medication prescribed has been withheld or missed in accordance with the Medication Management Procedure on MAR






Essential Policies & ProceduresBy the end of your 10 week familiarisation period it is expected that you have read the listed policies and procedures, and will apply these to your nursing practice. When you date and sign alongside each policy or procedure you are taking responsibility for ensuring you practice in accordance with these. Please note that there are a number of essential policies and procedures that relate directly to competencies. Where this is the case those policies and procedures have been included in the relevant competency assessment tool.Communication, documentation, privacyEffective management of inpatient length of stay and discharge planning procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=13504Open disclosure procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=7687Privacy procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6357Personal information – access procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6349Personal information – confidentiality procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6354Personal information – security procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6355Personal information – use and disclosure procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6347Email usage procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6336Internet usage procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=12577Professional conductCode of behaviour procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=10192 Code of conduct procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=9190Dress code – all RCH procedure/ http://www.rch.org.au/policy_rch/index.cfm?doc_id=6300Infection control principles- Clinical staff attirehttps://www.rch.org.au/policy/policies/Infection_Control_Principles_-_Clinical_Staff_Attire/Identification badges procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6338OHSRisk management policyhttp://www.rch.org.au/policy_rch/index.cfm?doc_id=8939Risk management procedure – for staffhttp://www.rch.org.au/policy_rch/index.cfm?doc_id=12325Occupational health and safety procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6416Occupational health and safety issue resolution procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6461OHS risk (hazard) management procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=6429Dangerous goods and hazardous substances procedurehttp://www.rch.org.au/policy_rch/index.cfm?doc_id=8938Emergency procedureshttp://www.rch.org.au/emergencyprocedures/ Emergency procedures – Code Greyhttp://www.rch.org.au/emergencyprocedures/code_greybrunarmed_confrontation/Code_Grey/ Emergency procedures – Code Blackhttp://www.rch.org.au/emergencyprocedures/code_blackbrarmed_confrontation/Code_Black/


http://www.rch.org.au/emergencyprocedures/code_blackbrarmed_confrontation/Code_Black/

http://www.rch.org.au/emergencyprocedures/code_greybrunarmed_confrontation/Code_Grey/

http://www.rch.org.au/emergencyprocedures/

http://www.rch.org.au/policy_rch/index.cfm?doc_id=8938







https://www.rch.org.au/policy/policies/Infection_Control_Principles_-_Clinical_Staff_Attire/

















Admission (Nursing)Competency Statement:The nurse safely and effectively admits patients and families. RCH references related to this competency: RCH intranet: Division Surgery- Surgery Resources, Operations- Admission into the Neonatal Care Unit;Banksia Ward Procedures: Admission to the Banksia Adolescent Inpatient UnitCompetency Exemptions: Outpatients, Theatres, Cardiac Theatres, RecoveryElement Exemptions: Day Medical, Emergency Department & RCH@Home (K1, S1); Banksia (S1, S3a & S3e)

COMPETENCY ELEMENTS

K 1. Discuss the purpose of providing “Preparing for home” envelope on admission2. Discuss how different referrals would be made for patients and families to allied health

teams and other support services based on the findings of a discharge risk screen

S 1. Provide families with the “Preparing for home” envelope on admission2. Demonstrate and document a nursing admission including:

a. Completion of admission assessment & care plan in ADT navigator on EMRb. Obtain personal / contact details c. Patient identification bracelet (or equivalent as per procedure) d. Identify presenting conditione. Conduct and record nursing assessment on admissionf. Complete the admission checklist in ADT Navigator

3. Demonstrate orientation of patient and family to the environment






ConsentCompetency Statement:The nurse demonstrates knowledge of the process for obtaining consent and applies that knowledge in practice.RCH references related to this competency: RCH Policies & Procedures – Consent – Informed, Procedural Safety-correct Patient, correct procedure, and correct site

COMPETENCY ELEMENTS

K 1. Locate and read the Consent – informed 2. Discuss when a documented consent is required3. Define informed consent4. Define implied consent5. Define what material risks are6. Identify the purpose of obtaining written consent7. Define the term “minor” in Victoria8. Discuss the notion of a “mature minor”9. Explain who can SEEK and who can GIVE consent10. Identify the requirements of a valid consent11. Outline the actions you would take if you were concerned that the consent was not valid12. Identify how long a consent is valid for13. Summarise the information that must be provided in seeking consent14. Discuss requirements for obtaining consent when there is a language barrier15. Outline the actions required when consent cannot be obtained or is refused16. Discuss when a court order is required17. Discuss situations where consent is not required18. Discuss how a situation in which consent has not been provided would be resolved19. State the location of consent forms in your department and their location in the EMR once

scanned.

S Not Applicable





Discharge Competency Statement:The nurse demonstrates safe and effective discharge of a patient. RCH Nursing Competency Workbook – Chapter 2 Page | 14

Competency Exemptions: Outpatients, Theatres, Cardiac Theatres, RecoveryElement Exemptions: Banksia (K2 & S5b); Day Medical (K1-2); Emergency Department (K1-2 & S3) & RCH@Home (K1-2 & K5a-b);

COMPETENCY ELEMENTS

K 1. Locate the Effective Management of Inpatient Length of Stay and Discharge Planning Procedure on the intranet

2. Explain to families how to use the “Preparing for home” envelope3. Discharge plans are clearly communicated and documented utilising white boards4. Discuss the cleaning and preparation of the bed space including Infection Control Guidelines5. Discuss proves involved regarding criteria led discharge and when this can be effectively

utilised in the clinical environment.

S 1. Complete the following elements of discharge planning / and document on the Discharge tab of the ADT navigator ensuring that:

a. Confirm GP details are correct utilising EMR b. Patient and family education is providedc. Follow up appointments are arrangedd. Post discharge services are in placee. Discharge equipment and /supplies are readyf. Patient and family understand use and storage of equipment/ suppliesg. Discharge medications are organisedh. Patient and family understand medicationsi. “After visit summary” is given to familyj. Discharge/Summary been organised to be given to family

2. Complete discharge entry in progress notes3. Discharge patient from IBA4. Demonstrate appropriate cleaning of bed space and preparation of oxygen and suction

supplies and equipment






Documentation: Admission to Discharge Competency Statement:The nurse demonstrates awareness of documentation standards and is able to write comprehensive, timely and relevant nursing notes that meet these standards. RCH references related to this competency: RCH Policies and Procedures – Documentation: Medical Records; Clinical Practice Guideline: Nursing Documentation; Clinical Practice Guidelines: Nursing AssessmentElement Exemptions: Banksia (S1e-f)

COMPETENCY ELEMENTS

K 1. Locate and read the Documentation: Nursing Documentation

S

1. Demonstrate Patient plan of care in EMRa. Parent education / involvementb. Observationsc. Fluid balanced. Medication plane. Wound caref. Pressure ulcer risk managementg. Falls risk assessmenth. ADL care needsi. Planned proceduresj. Discharge planningk. Holistic care

2. Documentation captured in patient’s progress notes in ‘real time’3. Demonstrate that nursing documentation meets the required standards, i.e.:

a. Each EMR progress note entry should follow ISBAR philosophy with a focus on four points of Assessment; Action ; Response; Recommendation

b. Entries are made as close to the time of an event occurring c. Ad. ll other paper documents are correctly identified with patient labels or a minimum of

patient’s full name, date of birth and UR e. entries have electronic signaturef. abbreviations used within the medical record are only those that are on the approved

RCH Abbreviations Listg. additional / late entries are identified as a "Late Entry" or "Additional Note"h. content includes a purpose of entry (e.g. admission note, progress note)i. content is objective, precise, accurate and factual, and sufficiently detailed to enable

another clinician to assume the care of the patient 4. Demonstrates evidence of nursing assessment in entries to clinical records5. Demonstrates evidence of evaluation of care provided.






Family Centred CareCompetency Statement:The nurse discusses and applies the principles of Patient and Family Centred Care in practice.RCH references related to this competency: RCH intranet: People & Culture – Patient and family-centred care; Medical Services-Patient Family Centred Care; RCH website: Knowing what to expect

COMPETENCY ELEMENTS

K 1. Locate and reada. Care planning and implementation policyb. Clinical handover procedurec. Child, family and community participation procedured. Consumer focused care policy e. Patient and family centred care proceduref. Culturally responsive care policyg. Interpreter and NESB services procedure h. Services to aboriginal people procedure

2. Identify the core principles that underpin the provision of patient and family centred care3. Explain resources available to patients and families at the RCH

S

1. Introduce self to patient and family2. Identify who is part of the patient’s family3. Undertake a family assessment4. Ensure patient and family dignity is preserved5. Treat all patients and families with respect6. Provide information in a way that is meaningful for patients and families7. Obtain information from patients, where able, and families to ensure that care is well

informed and consistent with patient and family needs8. Enable patients and families to participate to the level to which they choose9. Collaborate with patients and families to improve care and practise





Growth & Development of the Neonate (0-4 weeks)Competency Statement:


The Nurse discusses the growth and development of neonates aged 0–4 weeks and applies knowledge in practice.Competency Exemptions: Banksia RCH references related to this competency: RCH Clinical Guidelines (Nursing) & RCH Clinical Practice Guidelines – Thermoregulation in the Preterm infant; Environmental humidity for premature neonates; Jaundice in early infancy; Neonates; Apnoea (Neonatal);Neonatal hypoglycaemia; Neonatal Pain Assessment; Neonatal sleep maximisation in the hospital environment; Ward Management of a Neonate. Skin to skin care for the newborn. RCH Policy – Consumer Focused Care & Child Safety.

COCOON Intranet page https://www.rch.org.au/cocoon/about/Related reading and useful links: Neonatal Medicine (NICU) Intranet Resources - https://www.rch.org.au/neonatal_rch/ Neonatal ehandbook - https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/perinatal-reproductive/neonatal-ehandbook

COMPETENCY ELEMENTS

K 1. Identify the normal range of vital sign for neonates2. Describe the normal sleep / wake patterns of the neonate3. Discuss the following reflexes:

a. Root reflexb. Suck reflexc. Moro reflexd. Palmer / Grasp reflexe. Step reflexf. Tonic Neck reflexg. Planter / Babinski’s reflex

4. Discuss the physiology of thermoregulation in the neonate5. Discuss / demonstrate umbilical cord care & management including the natural process of

separation6. Discuss signs of cord infection7. Describe early signs of neonatal jaundice 8. Explain the management of physiological jaundice9. Identify other causes of jaundice in the neonate 10. Identify risks to maternal / infant bonding11. Discuss / demonstrate strategies to enhance maternal / infant bonding12. State the immunisation and screening process due in the first week of life

S1. Apply knowledge of growth and development to undertake a nursing assessment of the

neonate2. Apply knowledge of growth and development to carry out a procedure with a neonate3. Document the growth and development needs of a neonate on the nursing care plan4. Summarise/demonstrate education of parents regarding sleeping positions in line with SIDS

guidelines






https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/perinatal-reproductive/neonatal-ehandbook

https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/perinatal-reproductive/neonatal-ehandbook

https://www.rch.org.au/neonatal_rch/

https://www.rch.org.au/cocoon/about/

Growth and Development of the Infant (5 - 52 weeks)Competency Statement:The nurse discusses the growth and development of infants aged 5 - 52 weeks and applies knowledge in practice.Competency Exemptions: BanksiaRCH references related to this competency: Clinical Guidelines – Observation & Continuous Monitoring, Nursing Assessment. Anaesthesia and Pain Management Intranet page – https://www.rch.org.au/anaes/. RCH Policy – Consumer Focused Care & Child Safety. RCH Procedure – Patient and Family Centred Care.

Related reading and useful links: Spotting the Sick Child Website - https://www.spottingthesickchild.com Child Development Milestones (12 months)https://www.health.qld.gov.au/__data/assets/pdf_file/0024/426804/28129.pdf HealthVic Immunisation schedule: https://www2.health.vic.gov.au/public-health/immunisation/immunisation-schedule-vaccine-eligibility-criteria/immunisation-schedule-Victoria Victorian Child Health Record - https://www.betterhealth.vic.gov.au/health/healthyliving/victorian-child-health-record RCH Child growth learning resource - https://www.rch.org.au/childgrowth/ Kids Health Info Fact sheets (for parents) - https://www.rch.org.au/kidsinfo/ Merck Manual Childhood development http://www.merckmanuals.com/professional/pediatrics/growth-and-development/childhood-development NHS Child Development Ages and stages - http://www.cambscommunityservices.nhs.uk/what-we-do/children-young-people-health-services-cambridgeshire/specialist-services/childrens-speech-and-language-therapy/activities-ideas-and-info/child-development-ages-and-stages

COMPETENCY ELEMENTS

K 1. Identify the normal range of vital signs for the infant2. Describe key physical / motor changes occurring during normal infant development3. Describe key cognitive / language changes occurring during normal infant development4. Describe key social / emotional changes occurring during normal infant development5. Identify risks to infant development of illness and hospitalisation6. Discuss strategies to minimise risk to infant development of illness and hospitalisation7. Explain the purpose of the Victorian Child Health Record (green booklet was blue booklet)8. List the immunisations that are due in infancy

S1. Apply knowledge of growth and development to undertake a nursing assessment of an infant2. Apply knowledge of growth and development to carry out a procedure with an infant3. Document the growth and development needs (wellbeing) of an infant on the Nursing Shift

Plan (in Patient story).





Growth and Development of the Pre-schooler (1 - 4 years)Competency Statement:The nurse discusses the growth and development of toddlers/pre-schoolers aged 1 - 4 years and applies knowledge in practice. RCH Nursing Competency Workbook – Chapter 2 Page | 19

http://www.cambscommunityservices.nhs.uk/what-we-do/children-young-people-health-services-cambridgeshire/specialist-services/childrens-speech-and-language-therapy/activities-ideas-and-info/child-development-ages-and-stages



http://www.merckmanuals.com/professional/pediatrics/growth-and-development/childhood-development


https://www.rch.org.au/kidsinfo/

https://www.rch.org.au/childgrowth/

https://www.betterhealth.vic.gov.au/health/healthyliving/victorian-child-health-record

https://www2.health.vic.gov.au/public-health/immunisation/immunisation-schedule-vaccine-eligibility-criteria/immunisation-schedule-Victoria


https://www.health.qld.gov.au/__data/assets/pdf_file/0024/426804/28129.pdf

https://www.spottingthesickchild.com/

https://www.rch.org.au/anaes/

Competency Exemptions: BanksiaRCH references related to this competency: Clinical Guidelines – Observation & Continuous Monitoring, Nursing Assessment. Anaesthesia and Pain Management Intranet page – https://www.rch.org.au/anaes/. RCH Policy – Consumer Focused Care & Child Safety. RCH Procedure – Patient and Family Centred Care.

Related reading and useful links: Spotting the Sick Child Website - https://www.spottingthesickchild.com Child Development Milestones (1 year) https://www.health.qld.gov.au/__data/assets/pdf_file/0024/426804/28129.pdfChild Development Milestones (2 years)- https://www.health.qld.gov.au/__data/assets/pdf_file/0022/426811/28131.pdfChild Development Milestone (3 years) https://www.health.qld.gov.au/__data/assets/pdf_file/0016/427201/29098.pdf Child Development Milestone (4years) https://www.health.qld.gov.au/__data/assets/pdf_file/0030/427179/28132.pdf HealthVic Immunisation schedule: https://www2.health.vic.gov.au/public-health/immunisation/immunisation-schedule-vaccine-eligibility-criteria/immunisation-schedule-Victoria Victorian Child Health Record - https://www.betterhealth.vic.gov.au/health/healthyliving/victorian-child-health-record RCH Child growth learning resource - https://www.rch.org.au/childgrowth/ Kids Health Info Fact sheets (for parents) - https://www.rch.org.au/kidsinfo/ Merck Manual Childhood development http://www.merckmanuals.com/professional/pediatrics/growth-and-development/childhood-development NHS Child Development Ages and stages - http://www.cambscommunityservices.nhs.uk/what-we-do/children-young-people-health-services-cambridgeshire/specialist-services/childrens-speech-and-language-therapy/activities-ideas-and-info/child-development-ages-and-stages

COMPETENCY ELEMENTS

COMPETENCY ELEMENTS

K 1. Identify the normal range of vital signs for the toddler /pre-schooler2. Describe key physical / motor changes occurring during normal toddler/pre-schooler

development3. Describe key cognitive / language changes occurring during normal toddler/pre-schooler

development4. Describe key social / emotional changes occurring during normal toddler/pre-schooler

development5. Identify risks to toddler/pre-schooler development of illness and hospitalisation6. Discuss strategies to minimise risk to toddler/pre-schooler development of illness and

hospitalisation7. Explain the purpose of the Victorian Child Health Record (green booklet was blue booklet)8. List the immunisations that are due between the ages of 1 and 4

S1. Apply knowledge of growth and development to undertake a nursing assessment of a

toddler/pre-schooler2. Apply knowledge of growth and development to carry out a procedure with a toddler/pre-

schooler3. Document the growth and development needs (wellbeing) of an toddler/pre-schooler in the

Nursing Shift Plan (in Patient story).





Growth and Development of the School Aged Child (5 - 11 years) Competency Statement:The nurse discusses the growth and development of school aged children aged 5 - 11 years and applies knowledge in practice.


















Competency Exemptions: BanksiaRCH references related to this competency: Clinical Guidelines – Observation & Continuous Monitoring, Nursing Assessment. Anaesthesia and Pain Management Intranet page – https://www.rch.org.au/anaes/. RCH Policy – Consumer Focused Care & Child Safety. RCH Procedure – Patient and Family Centred Care.

Related reading and useful links: Spotting the Sick Child Website - https://www.spottingthesickchild.com HealthVic Immunisation schedule: https://www2.health.vic.gov.au/public-health/immunisation/immunisation-schedule-vaccine-eligibility-criteria/immunisation-schedule-Victoria Victorian Child Health Record - https://www.betterhealth.vic.gov.au/health/healthyliving/victorian-child-health-record RCH Child growth learning resource - https://www.rch.org.au/childgrowth/ Kids Health Info Fact sheets (for parents) - https://www.rch.org.au/kidsinfo/ Merck Manual Childhood development http://www.merckmanuals.com/professional/pediatrics/growth-and-development/childhood-development NHS Child Development Ages and stages - http://www.cambscommunityservices.nhs.uk/what-we-do/children-young-people-health-services-cambridgeshire/specialist-services/childrens-speech-and-language-therapy/activities-ideas-and-info/child-development-ages-and-stages

COMPETENCY ELEMENTS

K 1. Identify the normal range of vital signs for the school aged child2. Describe key physical / motor changes occurring during normal school aged child

development3. Describe key cognitive / language changes occurring during normal school aged child

development4. Describe key social / emotional changes occurring during normal school aged child

development5. Identify risks to school aged child development of illness and hospitalisation6. Discuss strategies to minimise risk to school aged child development of illness and

hospitalisation7. List the immunisations that are due between the ages of 5 and 11

S1. Apply knowledge of growth and development to undertake a nursing assessment of a school

aged child2. Apply knowledge of growth and development to carry out a procedure with a school aged

child3. Document the growth and development needs (wellbeing) of a school age child on the

Nursing Shift Plan (in Patient story).


















Growth and Development of the Adolescent (12+ years)Competency Statement:The nurse discusses the growth and development of adolescents aged 12 years plus and applies knowledge in practice.Competency Exemptions: Banksia (K7). All areas except Banksia (K8)RCH references related to this competency: Clinical Guidelines – Engaging with and assessing the adolescent patient, Observation & Continuous Monitoring, Nursing Assessment. Anaesthesia and Pain Management Intranet page – https://www.rch.org.au/anaes/. RCH Policy – Consumer Focused Care & Child Safety. RCH Procedure – Patient and Family Centred Care.

Related reading and useful links: RCH Adolescent Medicne Intranet page Spotting the Sick Child Website - https://www.spottingthesickchild.com HealthVic Immunisation schedule: https://www2.health.vic.gov.au/public-health/immunisation/immunisation-schedule-vaccine-eligibility-criteria/immunisation-schedule-Victoria Victorian Child Health Record - https://www.betterhealth.vic.gov.au/health/healthyliving/victorian-child-health-record RCH Child growth learning resource - https://www.rch.org.au/childgrowth/ Kids Health Info Fact sheets (for parents) - https://www.rch.org.au/kidsinfo/ Decision Making for individuals underage of 18 https://www.alrc.gov.au/publications/68.%20Decision%20Making%20by%20and%20for%20Individuals%20Under%20the%20Age%20of%2018/capacity-and-health-info Young People & Informed Consent http://www.nevdgp.org.au/info/privacy/Page3_Vol4_2004.pdf Merck Manual Childhood development http://www.merckmanuals.com/professional/pediatrics/growth-and-development/childhood-development NHS Child Development Ages and stages - http://www.cambscommunityservices.nhs.uk/what-we-do/children-young-people-health-services-cambridgeshire/specialist-services/childrens-speech-and-language-therapy/activities-ideas-and-info/child-development-ages-and-stages

Other community services: Child & Adolescent Mental Health Services http://www.health.vic.gov.au/mentalhealth/services/index.htm Orygen Youth Health https://oyh.org.au/ Young Peoples Health Service (FRONT YARD) http://www.frontyard.org/ Melbourne Sexual Health Centre http://www.mshc.org.au/ Action Youth Centre (Family Planning Victoria) https://www.fpv.org.au/our-reproductive-and-sexual-health-clinics Eating Disorders Victoria https://www.eatingdisorders.org.au/ Youth Support & Advocacy Service http://www.ysas.org.au/ Youth beyond Blue https://www.youthbeyondblue.com/ COMPETENCY ELEMENTS

K 1. Locate and Read Clinical Practice Guideline “Engaging with and assessing the Adolescent patient

2. Identify the normal range of vital signs for the adolescent3. Describe key physical / motor changes occurring during normal adolescent development4. Describe key cognitive / changes occurring during normal adolescent development5. Describe key social / emotional changes occurring during normal adolescent development6. Identify risks to adolescent development of illness and hospitalisation7. Discuss strategies to minimise risk to adolescent development of illness and hospitalisation8. Explain the HEADSS assessment tool 9. List the immunisations that are due between the ages of 12 and 18

S1. Apply knowledge of growth and development to undertake a nursing assessment of an

adolescent2. Apply knowledge of growth and development to carry out a procedure with an adolescent3. Document the growth and development needs (wellbeing) of an adolescent on the Nursing

Shift Plan (in Patient story).





Hydration - altered (Basic)Competency Statement:Provide safe and effective nursing care for patients with altered hydration.RCH Nursing Competency Workbook – Chapter 2 Page | 22

https://www.youthbeyondblue.com/

http://www.ysas.org.au/

https://www.eatingdisorders.org.au/

https://www.fpv.org.au/our-reproductive-and-sexual-health-clinics

http://www.mshc.org.au/

http://www.frontyard.org/

https://oyh.org.au/

http://www.health.vic.gov.au/mentalhealth/services/index.htm






http://www.nevdgp.org.au/info/privacy/Page3_Vol4_2004.pdf

https://www.alrc.gov.au/publications/68.%20Decision%20Making%20by%20and%20for%20Individuals%20Under%20the%20Age%20of%2018/capacity-and-health-info

https://www.alrc.gov.au/publications/68.%20Decision%20Making%20by%20and%20for%20Individuals%20Under%20the%20Age%20of%2018/capacity-and-health-info








RCH references related to this competency: RCH Clinical Practice Guidelines: Intravenous Fluids, Fluid Management in Meningitis, & Gastroenteritis, Nursing Assessment, Surgery – Perioperative Services-118 Fluid Management, Operations-Clinical Support Services-Pharmacy-Pharmacopoeia -Neonatal Intravenous (IV) Fluid Requirements, Division of Medicine-General Medicine-Clinical Practice Guidelines-DehydrationElement Exemptions: Banksia (K1, K10-14a-b), ACE Program (K1, K7, K12, K14)

COMPETENCY ELEMENTS

K 1. Locate and reada. RCH intravenous fluids clinical practice guidelineb. Dehydration clinical practice guideline

2. Describe the signs and symptoms of dehydration (mild, moderate, severe)3. Describe the signs and symptoms of over hydration4. Discuss how water gains can be measured5. Discuss how sensible water losses can be measured6. Identify causes of increased insensible losses7. State at least three conditions that can alter a patient’s hydration status 8. Describe how the conditions stated above alter a patient’s hydration status9. Discuss rationale for oral/nasogastric versus IV rehydration10. State the calculations (daily and hourly) for normal maintenance IV fluid rates for

a. Children 3 to 10kg b. Children 10-20kg c. Children > 20kg

11. Calculate the daily and hourly maintenance IV fluid rates for a child weighinga. 4kgb. 12kgc. 37kg

12. Discuss examples in which normal maintenance rates may be altered13. State the recommended intravenous fluid to be used as maintenance for well children with

normal hydration 14. State the minimum expected urine output in mls/kg/hr for a

a. Infantb. Toddler/pre-schoolerc. School age childd. Adolescent

15. State the fluid and calculation of bolus administration for hypovolaemia (e.g. in an emergency situation)

S1. Demonstrate assessment of a child’s hydration status and documentation of assessment

findings 2. Demonstrate accurate documentation of intake and output on a fluid balance Flowsheet3. Review the Fluid balance activity tab to review the patients progressive totals






HygieneCompetency Statement:The nurse identifies safe and effective care to meet the personal hygiene needs of infants, young children and adolescents. RCH references related to this competency: RCH Policy & Procedure Manual - Hand Hygiene;RCH Clinical Guidelines: Mouth Care –Oral Care of the paediatric oncology patient and haematopoietic stem cell transplant patient, Wash Up Competency Package (see Hand Hygiene Quiz);RCH Clinical Resources: Hand Hygiene Quiz;RCH Intranet: Kids Health Info - Hand Hygiene – why is it so important?PICU Intranet Guideline: Bathing patients in PIC, Oral Care in PICU GuidelineElement Exemptions: Banksia (K2)

COMPETENCY ELEMENTS

K 1. Discuss importance of attending to personal hygiene for children while they are hospitalised2. Describe personal hygiene care requirements of the neonate, infant, toddler/pre-schooler,

child and adolescent3. Identify equipment needed to attend to personal hygiene care4. Identify potential barriers to providing personal hygiene care and give examples of

strategies5. Identify strategies for maintaining privacy and dignity of the patient while attending to

personal hygiene

S 1. Demonstrate negotiation of personal hygiene care with patient and family2. Demonstrate accurate documentation of hygiene requirements and provision of hygiene

care





Infection Prevention Competency Statement:RCH Nursing Competency Workbook – Chapter 2 Page | 24

The nurse is aware of and compliant with the strategies/procedures in place at RCH to minimise the risk of transmission of infection between patients, staff and visitors Please note – that the following procedures are not addressed in this competency: Healthcare Workers with Infectious Diseases; Staff Immunisation - Prevention of Vaccine Preventable Diseases; Needle stick Injuries and Blood-Body Fluid Exposures

RCH references related to this competency: RCH Policy & Procedure Manual: Infection Control

COMPETENCY ELEMENTS

K 1. Locate and read:a. Standard precautions – infection control procedureb. Transmission based precautions – infection control procedurec. Multi resistant organismsd. Consumables in patient roomse. Cleaning, disinfection and sterilisation of reusable medical equipmentf. Linen managementg. Toys, play and educational equipment – Cleaning ofh. Infection Control Principles-Clinical staff attirei. Hand Hygienej. Events related sterilityk. Clinical waste and sharps management

2. Locate infection prevention and control webpage:a. Staff and family resourcesb. Table of infectious diseases

3. Describe the modes of transmission and precautions required for the management of a patient with a known or suspected infection

S 1. Demonstrate the principles of standard precautions, appropriate Personal Protective Equipment (PPE), Hand Hygiene, equipment cleaning and waste management

2. Demonstrate the principles of aseptic technique in practice






Intravenous Cannula Management - PeripheralCompetency Statement:The nurse demonstrates assistance with insertion of, and ongoing care of, peripheral intravenous cannulae. RCH references related to this competency: RCH Clinical Practice Guidelines: Intravenous access – Peripheral, Intravenous Fluids, Peripheral Intravenous (IV) Device Management; Procedural pain management and intravenous access-peripheral.RCH intranet: Surgery – Perioperative – 118 Fluid ManagementCompetency Exemptions: Banksia

COMPETENCY ELEMENTS

K 1. Identify suitable sites for insertion of peripheral IVs2. Apply local anaesthetic cream to insertion site3. Assemble correct equipment for peripheral IV insertion4. Assist in the insertion of a peripheral IV cannula5. State the frequency and criteria for replacement of a peripheral IV cannula 6. Describe the management of a peripheral IV cannula that does not have fluids running

through it

S 1. Demonstrate securing and dressing of peripheral IV cannula2. Demonstrate peripheral IV cannula inspection and document in LDA flowsheet3. Demonstrate removal of a peripheral IV cannula






Intravenous Fluid ManagementCompetency Statement:The nurse demonstrates safe management of children receiving intravenous fluids.RCH references related to this competency: RCH Clinical Practice Guidelines: Intravenous access – Peripheral, Intravenous Fluids, Peripheral Intravenous (IV) Device Management;RCH intranet: Surgery – Perioperative – 118 Fluid ManagementCompetency Exemptions: Banksia

COMPETENCY ELEMENTS

K 1. Locate and read the a. RCH intravenous fluids clinical practice guidelineb. RCH Paediatric Injectable Guidelines (PIG)c. peripheral intravenous device management clinical practice guideline

2. Differentiate between “Hard” and “Soft” limits when using Guardrails system3. Identify the type of IV transfusion lines available within the hospital ( minimum volume

extension line, SmartSite, Infusion Set, Burette Gravity Macro-Dropper set, Rapid Transfusion Pump Set)

4. Summarise IV bag and line change requirements whena. No additivesb. Additivesc. TPN/Lipidd. Central Line vs Peripheral line

5. Discuss the monitoring requirements for a child receiving IV fluids

S 1. Demonstrate checking procedure at the start of a new bag/syringe/rate change2. Demonstrate labelling for all IVs fluids & medications using RCH medication labels3. Demonstrate labelling of infusions with NO additives4. Demonstrate labelling of infusions WITH additives 5. Demonstrate procedure for indicating the flush of an additive through a line6. Demonstrate procedure for administering bolus/loading doses using Alaris Guardrails system7. Demonstrate ability to select correct program for department setting when using Guardrails

system8. Demonstrate ability to perform IV fluid additive calculations9. Prime a giving set with intravenous fluid10. Commence an intravenous infusion via an Alaris syringe driver and Alaris IV pump11. Demonstrate checking and documentation of

a. IV sitesb. Ratec. Infused volume






Monitoring (Basic)Competency Statement:The nurse demonstrates ability to safely and effectively monitor a patient.RCH references related to this competency: RCH Clinical guidelines: Nursing Assessment, Observation and Continuous Monitoring;RCH Intranet: Division of Medicine – Monitoring the Acute Patient Competency Exemptions: Banksia (K9-11)

COMPETENCY ELEMENTS

K 1. Identify the types of monitors available within the hospital ( Philips IntelliVue and Nellcor SpO2)

2. State instances when a patient will require cardio respiratory monitoring and/or saturation monitoring

3. Identify reasons for false alarming and discuss troubleshooting4. Discuss dangers associated with silencing alarms5. Identify suitable pulse oximetry probe sites6. State how often the pulse oximetry probe site should be assessed and changed7. State instances when a patient will require blood pressure measurements 8. Describe selection of the correct size cuff 9. Identify suitable sites for blood pressure measurement 10. Describe sinus rhythm 11. Identify common causes of artefact and their associated trouble shooting12. Discuss common paediatric arrhythmias and the response required

S 1. Demonstrate effective respiratory and saturation monitoring2. Demonstrate setting of alarm parameters3. Demonstrate placement of leads for a patient requiring 3 lead ECG monitoring






Enteral Feeding Competency Statement:The nurse safely and effectively cares for a patient with a nasogastric or orogastric tube. RCH references related to this competency: RCH Policies & procedures: Insertion of Nasogastric Tube policy: Clinical Guideline: Enteral Feeding and Medication Administration. RCH Intranet: Kids Health Info- Nasogastric tube - insertion ofElement Exemptions: ACE Program

COMPETENCY ELEMENTS

K 1. Locate and read Enteral Feeding and Medication Administration Clinical Guideline Identify reasons why child may have an enteral tube and the location of following

a. Orogastric tubeb. Nasogastric tube c. Nasojejunal tube d. Gastrostomy tube (gastrostomy-Button, Percutaneous Endoscopic Gastrostomy,

Temporary Balloon Device )e. Percutaneous Endoscopic jejunostomy

2. Discuss methods for securing and Enteral Tube 3. Describe what equipment is required to check the position of an Enteral Tube 4. Discuss the frequency for checking the placement of an Enteral Tube for

a. bolus feeds b. continuous feeds

5. Describe the documentation process for continuous enteral feeds 6. Discuss the care of a feeding set and how often they should be changed.7. Discuss the potential complications for Enteral Tubes 8. Discuss when flushing and venting of Enteral Tubes may be required

S 1. Demonstrate methods of securing an Enteral Tube nasogastric or orogastric tube2. Demonstrate how to withdraw a gastric aspirate required to check the placement of a

nasogastric or orogastric tube, and identify the volume required3. Demonstrate how to test the pH of a gastric aspirate Demonstrate how medications are administered via an Enteral Tube 4. Demonstrate how to heat an enteral feed5. Demonstrate administration of

a. bolus feedsb. continuous feeds






Nutritional Requirements Competency StatementThe nurse provides safe and effective care to meet the nutritional needs of unwell infants and children.RCH references related to this competency: RCH Intranet: Division of Medicine-Dietary Management Of Chronic Renal Failure, Division of Medicine- Nutrition In Acute Renal Failure, Division of Medicine- Nutrition after renal transplant Surgery-Nutritional management for burn patients; Neonatal Medicine-Parenteral Nutrition in the Newborn Intensive Care UnitRCH intranet Kids Health Info-Breastfeeding a baby in hospital, breastfeeding at The Royal Children’s HospitalRCH Clinical Guidelines: Breastfeeding support and promotion, Parental Nutrition PNElement Exemptions: Banksia (K1b, K5-8, K10-11)

COMPETENCY ELEMENTS

K 1. Locate and read a. breast feeding support and promotion clinical guideline (hospital)b. parenteral nutrition (PN) clinical guideline (hospital)

2. Obtain and document nutrition history and requirements-documentation conducted on nursing admission

3. Give examples of when patients might have special dietary requirements4. Describe the process for referral to a dietician5. Discuss the facilities and resources available to support breast feeding mothers6. Explain the following in relation to expressed breast milk:

a. labelling requirementsb. storagec. checking procedure of EBMd. location of central formula room and expressing rooms on units

7. Identify how to order and store:a. bottles and teatsb. standard infant formulasc. enteral feeds or specialised/modified infant formulas

8. Explain the process for ordering patient meals9. State the indications for the commencement of PN10. Outline the steps for ordering PN11. Outline the resources available for management of PN in the clinical environment12. Documentation of PN

S 1. Demonstrate documentation of nutritional intake 2. Document assessment of patient nutrition and hydration3. Fluid balance recording4. Checking of PN solution, connection/running of intravenous PN Infusions5. Monitoring of Patient on PN solution





Oxygen TherapyCompetency Statement:RCH Nursing Competency Workbook – Chapter 2 Page | 30

The nurse safely and effectively administers oxygen therapy.RCH references related to this competency: RCH Clinical guidelines: Oxygen delivery, Oxygen Saturation SpO2 Level Targeting - Premature Neonates; High Flow Nasal Prong HFNP guideline Element Exemptions: ACE Program (K8, K9, K11, K12, S3, S5)

COMPETENCY ELEMENTS

K Locate and read the RCH clinical guidelines: Oxygen delivery Oxygen Saturation SpO2 Level Targeting-Premature Neonates; High Flow Nasa prong ( HFNP therapy ) Sugar glider, E.D., Koala only

1) Describe and differentiate the mechanisms of ventilation, diffusion, and respiration. 2) Define Peak Inspiratory Flow Rate3) State the normal SpO2 range for

a) Children/adultsb) Neonates (premature or less than 28 days of age) nursed in oxygenc) Cyanotic heart disease

4) Describe the signs and symptoms of hypoxia 5) State the aims of oxygen therapy6) State potential complications and hazards associated with oxygen therapy7) Identify factors taken into consideration in selecting oxygen delivery methods8) Differentiate between High flow and Low flow oxygen delivery systems9) State minimum and maximum flow rates deliverable via:

a) Simple face maskb) Nasal prongs for children less than 2 years and children older than 2 years, c) Humidified nasal prongs for children less than 2 years and children older than 2 years.

10)Describe the process for initiating or altering oxygen delivery11)Describe the application and maintenance of a non re breather mask for emergencies

S 1. Demonstrate application and maintenance of each of the following for a child receiving oxygen therapy via:

a. Nasal prongs-wallb. Simple face mask

2. Demonstrate set up and application of humidified oxygen therapy via Airvo, for:a. Humidified nasal prong oxygenb. Humidified face mask oxygen

3. Demonstrate clinical assessment of a patient receiving oxygen therapy4. Document assessment of a patient receiving oxygen therapy5. Evaluate patient response to oxygen therapy6. Assemble equipment for portable oxygen delivery






Pain assessment and management (basic)Competency Statement:The nurse will effectively assess and take all steps to manage pain.RCH references related to this competency: RCH Intranet: Surgery-Acute Pain Management CPMS, Surgery-Chronic Pain Management CPMS, Surgery-Links - Anaesthesia Pain Management, Surgery- Parent Info - Anaesthesia Pain Management

COMPETENCY ELEMENTS

K 1. Locate and read the a. RCH pain assessment module and clinical practice guidelineb. Completion of Opioid primary & other pain service e-learning competencies

(assigned based on area requirements)2. Discuss cultural and past experiences that may affect a child’s pain3. Discuss the impact of untreated or inadequately managed pain4. Describe the pain assessment tools used in paediatrics at RCH5. Identify which pain assessment tools are most useful for different developmental stages and

children with developmental disabilities6. Discuss appropriate language when assessing pain7. Discuss options for pharmacological management of pain 8. Discuss options for non-pharmacological management of pain9. Discuss nursing actions to take if pain escalates10. Identify resources available to assist in pain management

S 1. Demonstrate assessment of pain during: a. restb. activity c. post-operatived. procedures

2. Demonstrate family inclusion in pain assessment and decision making3. Demonstrate documentation of pain assessment in observation flowsheet






Preparation for Surgery and Pre-Anaesthetic Care Competency Statement:The nurse will safely and effectively prepare and care for a patient pre surgery/ anaesthetic.RCH references related to this competency: RCH Intranet: Division of Medicine-General Medicine-Clinical Practice Guidelines-Fasting Guidelines, Surgery-Intranet Resources - Anaesthesia Intranet Only, Surgery-Parent Info - Anaesthesia Pain ManagementElement Exemptions: Banksia (K3a)

COMPETENCY ELEMENTS

K 1. Explain the required paperwork for a patient prior to an anaesthetic2. Summarise the baseline observations required prior to an anaesthetic3. Outline fasting guidelines for

a. Breast milkb. Clear fluidsc. Other liquidsd. Solids

4. Outline patient and parent education and preparation for theatrea. Discuss the process for escorting patients to theatreb. State the appropriate attire for patients presenting for theatrec. Discuss parents role in accompanying and supporting child throughout anaesthetic

and recovery process5. Outline common premedications given and monitoring required6. Discuss what medications should/shouldn’t be withheld prior to anaesthetic/ surgery

S 1. Demonstrate baseline assessment and documentation within the ADT navigator2. Demonstrate completion of preoperative checklist 3. Demonstrate transport and handover to a pre-operative nurse4. Demonstrate how to locate and read the theatre list and time line






Procedural Pain Management (Basic)Competency Statements:The nurse assesses and implements basic non pharmacological and pharmacological strategies to minimise anxiety, distress and pain as part of routine procedure care. The nurse educates and models developmentally appropriate strategies that enable the parent and child to develop positive coping skills for routine procedure. RCH references related to this competency: RCH Clinical guidelines: Sedation - Procedural Sedation Guideline - Ward and Ambulatory AreasPlease note that there are specialty nursing competencies for IV sedation and Nitrous oxide administration

COMPETENCY ELEMENTS

K General:1. Locate and read

a. Procedural Pain Management procedureb. Procedural Pain Management clinical guidelinec. Procedural Sedation clinical guideline

2. Discuss the nurse’s role in advocacy for procedures3. Discuss the Educational Play Therapist role for procedures4. Discuss management of

a. unresolved/untreated pain and anxiety and b. the number of procedural attempts

Pharmacology Strategies:5. State the differences between administration of same agents for:

a. Proceduralb. Nocturnalc. Pre medication

Non pharmacology Strategies:6. State the resources available to assist children/families and health care staff to manage

procedural pain, fear and distress7. List department and RCH services available to support children who are moderately or

extremely distressed during procedures8. Discuss non pharmacological strategies available for procedural pain management9. Describe the role of parental and child decision making for procedures including coping

strategies10. State differences between a procedural explanation and preparation of the child/family for

procedures11. Describe the preparation required for procedures that are common in your department 12. Discuss the use of sucrose for procedural pain management including:

d. Dosagee. Site selection f. Durationg. Documentation

S Pharmacology Strategies:1. Demonstrate the appropriate and safe use of topical and local anaesthetic agents including:

a. Dosageb. Site selectionc. Durationd. Documentation

2. Demonstrate the appropriate and safe use of oral procedural sedation agents including:a. Dosage b. Routec. Duration d. Documentation

Non-Pharmacology Strategies:3. Demonstrate the use of positioning and distraction strategies for common procedures in

your departmentCompetency Declaration over page






Post-Sedation/-Anaesthetic Care Competency Statement:The nurse will safely and effectively care for a patient post sedation or anaesthetic.RCH references related to this competency: RCH Clinical Guidelines: Sedation - Procedural Sedation Guideline - Ward and Ambulatory Areas;


RCH Intranet: Kids Health Info-Sedation for procedures 1: About sedation, Surgery-Links - Anaesthesia Pain Management, Surgery-Intranet Resources - Anaesthesia Intranet Only Competency Exemptions: Banksia (K1-7 & S1-4)

COMPETENCY ELEMENTS

K 1. Discuss the patient’s surgery/procedure2. Outline type, frequency and duration of post sedation/anaesthetic observations3. Discuss rationale for intravenous fluid orders, oral intake 4. Explain potential impact of procedure on output5. Summarise the pain management plan for a child post procedure, including analgesic

infusions, wound catheters, epidural and local anaesthetic techniques6. Identify factors that contribute to post procedure nausea and vomiting and its management

and appropriate intervention7. Identify potential post procedure complications

S 1. Demonstrate bedside checks2. Demonstrate assessment and documentation of observations, fluid status and relevant

surgical assessment3. Demonstrate pain assessment post procedure4. Demonstrate wound assessment and documentation





Risk Screening & ManagementCompetency Statement:The nurse maintains a safe and healthy environment when caring for patients.RCH references related to this competency: RCH Policies & Procedures: Clinical Waste and sharps management, Code Grey Procedure, Incident/Injury/Hazard Reporting, Incident Reporting and Management, Needle stick injuries and blood/body fluid


exposures procedure, Occupational violence procedure, Patient Identification, Procedural Safety – Correct Patient, Correct Procedure, Correct SitePlease note that pressure ulcer prevention and management is addressed in skin integrity competency tool and infection prevention is addressed in the infection prevention competency tool.

COMPETENCY ELEMENTS

K 1. Locate and reada. Patient identification procedureb. Incident / Injury / Hazard reporting procedurec. Falls prevention procedured. Vulnerable children policye. Child protection proceduref. Code of behaviour procedureg. Code grey procedureh. Occupational violence procedurei. Clinical waste and sharps managementj. Sharps handling procedurek. Needle stick injuries and blood / body fluid exposures procedure

2. Identify and act upon potential safety hazards in the environment3. Describe the process of “procedure matching” as per the patient identification procedure 4. Describe the rationale and documentation for recording information about allergies and

reactions5. Summarise the identification and management of vulnerable children6. List the RCH expectations of staff in compliance with the Code of behaviour procedure7. Discuss the responsibility of clinical staff in the event of clinical aggression8. Summarise the procedure for sharps disposal 9. Outline the procedure for managing a needle stick injury10. Describe the process for incident reporting via VHIMS

S 11. Demonstrate care consistent with falls prevention procedure12. Undertake a safety check of bedside equipment 13. Demonstrate correct positive patient identification technique






Skin IntegrityCompetency Statement:The nurse provides safe and effective care for a patient at risk of or with existing skin breakdown. RCH references related to this competency: RCH Clinical Guideline: Environmental Humidity for Premature Neonates, Perianal care for the Paediatric Oncology Patient, Pressure Injury Prevention and Management, Tracheostomy Tube Ties - procedure for changing

COMPETENCY ELEMENTS

K 1. Locate and read the Pressure Ulcers Prevention and Management guideline2. Define a pressure ulcer3. Discuss when a patient should be assessed for risk of pressure ulcer development4. Identify risk factors for the development of pressure ulcers 5. Describe preventative strategies used to reduce the likelihood of pressure ulcer

development6. Describe the role of positioning in the prevention of pressure ulcers 7. Identify areas of skin at increased risk for pressure ulcer development including the rationale8. State the initial signs of pressure ulcer development9. Discuss the process for management of a patient with a pressure ulcer 10. List pressure relieving devices appropriate for patients at:

a. Low to moderate risk of developing a pressure ulcerb. High to very high risk of developing a pressure ulcer and without existing skin

breakdownc. High to very high risk patients with existing skin breakdown, immobile and high,

perspiration

S 1. Demonstrate a pressure ulcer risk assessment using the Glamorgan Scale2. Demonstrate a Falls risk assessment using the Little Schmidy Scale3.





Transfer of PatientsCompetency Statement:The nurse safely and effectively transfers patients within the hospital and to external organisations.


RCH references related to this competency: RCH Policies & Procedures: Non-Emergency Patient Transport, Non-Emergency patient transport (NEPT) webpage-wizard flowchart: Nursing documentation (clinical guidelines)

COMPETENCY ELEMENTS

K 1. Locate and read the patient transport resources available2. Identify equipment necessary to ensure safety of patient during transfer3. Discuss documentation necessary to accompany patient transferring to:

a. An inpatient unitb. An appointment in another departmentc. Theatred. Another organisation

4. Discuss the relevant OHS considerations when transferring a patient within the hospital5. Identify transport options for patient transfer to an external organisation

S 1. Arrange date and time for transfer with area receiving patient2. Demonstrate how you prepare a patient for transfer 3. Ensure privacy and dignity of the patient and family are maintained during transfer





Wound Assessment & ManagementCompetency Statement:The nurse provides safe and effective care for a patient requiring wound care.RCH references related to this competency: RCH Clinical Guideline: Wound Care; RCH Policy: Antiseptic technique


COMPETENCY ELEMENTS

K 1. Locate and Read the Wound Care clinical Guideline2. Describe the three phases of wound healing3. Discuss the considerations for wound assessment, including:

Wound bed Wound measurement Wound edges Exudate Infection Pain Surrounding skin

4. Discuss factors delaying wound healing5. State the objectives of acute and ongoing wound management6. Describe the differences in aseptic technique used in wound management

Standard Aseptic Technique Surgical Aseptic Technique

7. Discuss considerations when choosing dressing products

S 1. Demonstrate a wound dressing requiring: Standard Aseptic Technique Surgical Aseptic Technique

2. Appropriately document: Wound assessment in LDA flowsheet Dressing products used Analgesia required Multidisciplinary team involvement (e.g. play therapy, stomal therapy) Plan for further wound care and management





CVAD Management (*likely to change at RCH during 2018 due to ‘The Line Project’ initiative)

Competency Statement:The nurse safely and effectively cares for a patient with a central venous access device (CVAD). RCH references related to this competency: RCH Policies & Procedures: Central Venous Access Device Management;RCH Intranet: Division of Medicine-Guidelines for the Management Blocked Central Venous Lines


Competency Exemptions: Banksia

COMPETENCY ELEMENTS

K 1. Locate and read the CVAD clinical guideline2. Locate and complete the CVAD education package and quiz3. Differentiate between a peripheral IV access device and a CVAD4. Discuss the indications for central venous access5. Identify possible routes and devices for central venous access 6. Differentiate between standard aseptic technique and surgical aseptic technique7. State which technique to use when performing dressing and smart site change on a CVAD8. State which technique to use when preparing and administering drugs via a CVAD9. State which technique to use when changing IV administration sets connected to a CVAD10. State indications for dressing change and smart site change of CVAD11. Discuss the correct blood sampling technique 12. Discuss potential complications associated with CVADs and appropriate management13. Discuss the management of a blocked CVAD and anticoagulant guidelines

S 1. Demonstrate CVAD site inspection2. Demonstrate correct standard aseptic technique when preparing medications for

administration via a VCAD3. Demonstrate correct surgical aseptic technique for CVAD dressing and /or smart site change 4. Demonstrate correct surgical aseptic technique for port cannulation5. Demonstrate access of CVAD for medication administration using standard aseptic technique6. Demonstrate correct disinfection of smart site prior to accessing it7. Demonstrate CVAD line change8. Demonstrate disconnection of lines and flushing of a CVAD9. Demonstrate correct blood sampling technique from a CVAD10. Document CVAD management on the LDA flowsheet





* ‘The Lines Project: A multi-site approach to managing lines’ is an 18 month project led by Kerrie Curtis that will lead to changes to the way CVAD’s are managed at RCH & Monash Children’s Hospital.

The Lines Project aims to establish and implement a systematic, evidence-based and consistent approach to Central Venous Access Device (CVAD) selection, insertion, maintenance and removal for all neonates and paediatric patients up to 18 years.

Project Leads are Dr Ed Oakley at RCH and Dr Richard Barnes, MCH supported by the Nursing Leadership team. At RCH we also have a Clinical Nurse Consultant, Vascular Access, Eloise Borello who will be pivotal in our local work at RCH.

Haematology and Biochemistry (Basic)Competency Statement: The nurse is able to identify normal basic biochemistry results, the causes of abnormal results and is able to respond appropriately.RCH references related to this competency: RCH Intranet: Division of Medicine – Intranet Resources – Haematology, Operations – Laboratory Services

COMPETENCY ELEMENTS


K 1. Identify reasons for monitoring basic biochemistry for patients common to your clinical area2. Identify reasons for monitoring basic haematology for patients common to your clinical area3. State the normal reference ranges for

a. Haemoglobinb. Plateletsc. White blood cellsd. Neutrophils

4. Identify potential causes of high or lowa. Haemoglobinb. Plateletsc. White blood cellsd. Neutrophils

5. State the normal reference ranges for a. Creatinineb. Ureac. Sodiumd. Potassiume. Chloridef. Bicarbonateg. Glucose

6. Identify potential causes of high or lowa. Creatinineb. Ureac. Sodiumd. Potassiume. Chloridef. Bicarbonateg. Glucose

7. Discuss action required when results fall outside the normal reference range

S 1. Demonstrate use of “Results review” activity tab in EMR to review biochemistry results






Tube InsertionCompetency Statement:The nurse is able to safely insert, secure & confirm positioning of a nasogastric tube.RCH references related to this competency: RCH Intranet: Kids Health Info – Nasogastric tube – insertion of;RCH Policies & Procedures: Insertion of Nasogastric Tube

COMPETENCY ELEMENTS

K 1. Locate and read the “Insertion of Naso-Gastric Tube” procedure2. Identify the reasons why a patient may require a nasogastric tube (NGT)3. Discuss the differences including frequency of tube changing and rationale for insertion

between long term and short term NGT4. Identify the anatomical position of where the tip of the NGT is placed5. Discuss how confirmation of tube position is obtained6. Describe the methods for securing a NGT for patients with:

a. intact skin b. neonatesc. eczemad. burns

7. Discuss management of possible complications that may occur during NGT insertion8. Discuss appropriate resources available in preparing the patient and family for tube

placement9. Discuss patient types and groups where nasogastric and orogastric tubes should be inserted

by medical personnel

S 1. Select equipment for insertion, testing & securing of NGT2. Demonstrate how to measure the length of tube to be inserted 3. Demonstrate insertion of a NGT4. Demonstrate testing of NGT placement5. Demonstrate securing of a NGT6. Complete accurate documentation of NGT insertion in LDA flowsheet






Specimen CollectionCompetency Statement:The nurse safely and effectively collects specimens, checks results and responds appropriately.RCH references related to this competency: RCH Intranet: Operations – Laboratory Services – Specimen collection details, Operations – Specimen Collection; RCH Policies & Procedures ; Collection of Capillary Blood samples; Clinical Practice Guidelines: Lumbar puncture, NPA, Newborn Screening Test, Supra Pubic Aspirate, Urinary tract infection.

COMPETENCY ELEMENTS

K 1. Locate the RCH specimen collection handbook 2. Locate and read the RCH specimen collection policy 3. List the information required on a specimen collection request slip4. Discuss common pre-analytic specimen problems (PASP’s) and the prevention strategies5. Differentiate between the following urine specimen collection techniques:

a. Clean Catch b. Mid-Stream Urinec. Supra Pubic Aspirated. Catheter Specimen

6. Describe the capillary blood specimen collection 7. Describe faecal specimen collection8. Describe the four different respiratory virus PCR collection methods available9. Differentiate between viral and bacterial specimen collection equipment10. Explain rationale for plating swabbed specimens11. Discuss actions when abnormal results are obtained12. Describe indications for lumbar puncture13. Describe and demonstrate the nurse’s role when assisting with an LP14. Discuss correct order of draw when collecting blood samples

S 1. Demonstrate application of urine specimen bag2. Demonstrate ‘dip-stick’ testing of urine and interpretation of results3. Demonstrate correct capillary blood specimen collection by finger prick and heel prick4. Demonstrate correct specimen labelling requirements 5. Demonstrate use of “Results review” activity tab in EMR to review pathology results6. Demonstrate correct technique for Newborn Screening test7. Demonstrate correct technique for samples transported on ice8. Demonstrate correct technique for venepuncture






Transfusion Management (Red Blood Cell)Competency Statement:The nurse will safely administer red cell red blood cells according to best practice guidelines.RCH references related to this competency: RCH Intranet: Operations – Laboratory Services – Adverse effects of transfusion, Division of Medicine – General Medicine – Clinical Practice Guidelines-Blood product transfusion Competency Exemptions: Banksia

COMPETENCY ELEMENTS

K 1. Locate and read the a. blood transfusion procedureb. blood product transfusion clinical practice guidelinec. blood transfusion – consent and consumer information clinical guideline (Hospital)

2. Define the normal range for Haemoglobin 3. Describe the signs and symptoms of anaemia4. Discuss supportive management for the symptoms of anaemia5. Explain why some patients receive blood products that are:

a. Irradiatedb. CMV negative

6. Identify how soon after release from blood bank the transfusion of a product should commence

7. Identify over what period of time a blood transfusion must be completed once a bag is spiked

8. State the formula for calculating the transfusion volume9. Identify when filters should be changed10. Summarise the monitoring requirements of a patient during a blood transfusion11. Describe the signs and symptoms of a blood transfusion reaction12. Discuss the steps in recognising and managing a transfusion reaction

S 1. Demonstrate correct collection and labelling of pre transfusion sample2. Correctly fill in a blood bank release order3. Demonstrate the correct pre transfusion check

a. Patient preparationb. Patient identificationc. Blood product identificationd. Blood Groupe. Expiry datef. Inspection of productg. Documentation

4. Select the correct filter for the transfusion






Competency Feedback & ReflectionThis section is used to document constructive feedback relating to specific elements of any competency from assessors, and also provides space to document reflection on your own practice (either in direct relation to the feedback, or separately).Competency Name:Element(s):Assessor Feedback:

Self-Reflection:

Assessor [sign and date] Nurse [sign and date]

Competency Name:Element(s):Assessor Feedback:

Self-Reflection:



Self-Reflection:


Competency Feedback & ReflectionThis section is used to document constructive feedback relating to specific elements of any competency from assessors, and also provides space to document reflection on your own practice (either in direct relation to the feedback, or separately).Competency Name:


Element(s):Assessor Feedback:

Self-Reflection:



Self-Reflection:



Self-Reflection:


Competency Feedback & ReflectionThis section is used to document constructive feedback relating to specific elements of any competency from assessors, and also provides space to document reflection on your own practice (either in direct relation to the feedback, or separately).Competency Name:Element(s):


Assessor Feedback:

Self-Reflection:



Self-Reflection:



Self-Reflection:




Self-Reflection:



Self-Reflection:



Self-Reflection:



Self-Reflection:




Self-Reflection:



Self-Reflection:



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